<wicket:panel>
	<br />
	<br />
	<div class="well">
		<form id="tab" class="form-horizontal" wicket:id="form">
			<fieldset>
				<div class="span4 smvlabel">
					<!-- Text input-->
					<div class="control-group">
						<label class="control-label" for="textinput">Company</label>
						<div class="controls">
							<input id="textinput" name="textinput" placeholder="Company"
								class="input-large" type="text" wicket:id="name">
						</div>
					</div>

					<!-- Text input-->
					<div class="control-group">
						<label class="control-label" for="Address1">Address Line1</label>
						<div class="controls">
							<input id="Address1" name="Address1" placeholder="Address Line1"
								class="input-large" type="text" wicket:id="line1">
						</div>
					</div>
					<div class="control-group">
						<label class="control-label" for="Address2">Address Line2</label>
						<div class="controls">
							<input id="Address2" name="Address2" placeholder="Address Line2"
								class="input-large" type="text" wicket:id="line2">
						</div>
					</div>
					<div class="control-group">
						<label class="control-label" for="City">City</label>
						<div class="controls">
							<input id="City" name="City" placeholder="City"
								class="input-large" type="text" wicket:id="city">
						</div>
					</div>
					<div class="control-group">
						<label class="control-label" for="State">State</label>
						<div class="controls">
							<input id="State" name="State" placeholder="State"
								class="input-large" type="text" wicket:id="state">
						</div>
					</div>

					<!-- Select Basic -->

					<div class="control-group">
						<label class="control-label">Company/Taxi</label>
						<div class="controls">
							<span wicket:id="roleTaxiCompany" id="radio"></span>
						</div>
					</div>

					<div class="control-group">
						<label class="control-label" for="Sector">Company Sector</label>
						<div class="controls">
							<input id="Sector" name="Sector" placeholder="CSector"
								class="input-large" type="text" wicket:id="sector">
						</div>
					</div>

					<!-- Text input-->
					<div class="control-group">
						<label class="control-label" for="PhoneNo">Phone No</label>
						<div class="controls">
							<input id="PhoneNo" name="PhoneNo" placeholder="Phone No"
								class="input-large" type="text" wicket:id="mobileNo">
						</div>
					</div>
				</div>
				<div class="span4 offset1 smvlabel">
					<!-- Textarea -->
					<div class="control-group">
						<label class="control-label" for="Areas">Areas</label>
						<div class="controls">
							<textarea id="Areas" name="Areas" wicket:id="areas">default text</textarea>
						</div>
					</div>

					<!-- Select Multiple -->
					<div class="control-group">
						<label class="control-label" for="Branches">Branches</label>
						<div class="controls">
							<select id="Branches" name="Branches" wicket:id="branches"
								class="input-large" multiple="multiple">
								<option>Bangalore</option>
								<option>Chennai</option>
								<option>Gurgaon</option>
							</select>
						</div>
					</div>

					<!-- Text input-->
					<div class="control-group">
						<label class="control-label" for="Rate">Rates</label>
						<div class="controls">
							<input id="texRatetinput" name="Rate" placeholder="Rates"
								class="input-medium" type="text" wicket:id="rate">
						</div>
					</div>

					<!-- Select Basic -->
					<div class="control-group">
						<label class="control-label" for="EmployeeNo">Employees</label>
						<div class="controls">
							<select id="EmployeeNo" name="EmployeeNo" class="input-large"
								wicket:id="employeeNumber">
								<option>1 - 10</option>
								<option>1 - 100</option>
								<option>1 - 200</option>
							</select>
						</div>
					</div>

					<!--     <!-- Text input-->
					<!-- <div class="control-group">
					<label class="control-label" for="textinput">Add Vehicle</label>
					<div class="controls">
						<input id="textinput" name="textinput" placeholder="Add Vehicle"
							class="input-large" type="text">

					</div>
				</div>
				add more
				<div class="control-group">
					<label class="control-label" for="textinput"></label>
					<div class="controls">
						<a href="#">Add More Vehicle</a>

					</div>
				</div> -->

					<!-- Button (Double) -->
					<div class="control-group">
						<label class="control-label" for="button1id"></label>
						<div class="controls">
							<button id="button1id" class="btn btn-primary"
								wicket:id="register">Register</button>
							<button type="reset" class="btn ">Reset</button>
						</div>
					</div>
				</div>
			</fieldset>
		</form>
		<span wicket:id="vehicle"></span>
	</div>
</wicket:panel>